Ottens, Allen J.
Ed.D. (Doctor of Education)
Department of Counseling, Adult and Higher Education
Fibromyalgia--Psychological aspects; Fibromyalgia--Physiological aspects
This investigation attempted to determine neuropsychological differences in fibromyalgia (FMS) patients as well as the roles of pain and depression. It sought to explain differences in terms of the Reitan-Wolfson Model. This study, an ex post facto design, used 4 groups (n = 40); FMS, major depression (DEP), rheumatoid arthritis (RA), and a control (NC). Assessment battery included the Beck Depression Inventory (BDI), McGill Pain Questionnaire (MPQ), Halstead-Reitan Neuropsychological Battery (HRNB), and Health History. Complex comparisons assessed differences in depression, pain, and neuropsychological deficits. Discriminant analysis was used to predict group membership. Univariate results revealed that DEP was significantly more depressed than FMS, RA, and NC and that FMS was significantly more depressed than RA and NC. Results showed that FMS experienced significantly more pain on all 7 measures of the MPQ when compared to DEP, RA, and NC and the RA experienced significantly more pain than DEP and NC. Results on the HRNB revealed that the FMS experienced significant neuropsychological impairment on 11 of 19 measures including 6 of 7 measures of the Impairment Index when compared to DEP, RA, and NC. The DEP experienced some neuropsychological impairment that was not significant. Results suggest that impairment occurs at level three of the Reitan-Wolfson Model. Results from discriminant analysis revealed that different measures could predict group membership correctly from 52.2% using just the HRNB to 94.4% using the HRNB, BDI, and MPQ. Results suggest that scores on the MPQ (pain) and BDI (depression) are the most important symptoms in the diagnosis of FMS and that neurocognitive symptoms are important secondary symptoms. Results suggest that neither pain nor depression, alone, causes the significant neuropsychological impairment experienced by FMS patients. FMS is viewed as a complex combination of pain, depression, and biological changes within the brain, acting together to create a complex clinical picture which includes neuropsychological impairment. Simple paper and pencil tests could improve diagnostic accuracy. Practitioners must take patients' neuropsychological complaints seriously. Educational approaches should be directed at practitioners and patients. Finally, treating FMS patients using rehabilitative techniques, such as REHABIT, may prove beneficial.
Mangold, Richard F., "Neuropsychological changes in fibromyalgia" (2003). Graduate Research Theses & Dissertations. 4109.
xviii, 264 pages
Northern Illinois University
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